Disorganization and Musculoskeletal Diseases: Novel Insights into the Enigma of Unexplained Bone Abnormalities and Fragility Fractures.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Roger Zebaze, Peter Robert Ebeling
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引用次数: 4

Abstract

Purpose of review: Describe the potential contribution of disorganized tissue to the pathogenesis of bone abnormalities and fractures. Especially, fractures that are unexplained by bone loss (osteoporosis) or structural deterioration.

Recent findings: Currently, bone fragility is primarily viewed as due to loss, or decay (osteoporosis). However, it is also acknowledged that this view is limited because it does not explain many fractures or abnormalities such as necrosis, sclerosis, or infarcts. Atypical femoral fractures (AFFs) during antiresorptive therapy are an example. Hence, it is proposed that another distinct mechanism is responsible for bone diseases. A remarkable bone property distinct from mass and decay is the organization (arrangement) of its components. Components must be perfectly assembled or well-stacked to ensure "the right amount of bone, at the right place". Disorganization is an aberration that is conspicuous in many diseases, more so in conditions poorly associated with bone mass and decay such as osteogenesis imperfecta, hypophosphatasia, and AFFs. However, despite the likely critical role of disorganization, this feature has received limited clinical attention. This review focuses on the potential contribution of disorganization to bone in health and diseases. Particularly, we propose that disorganization, by causing ineffective transfer of loads, may produce not only bone abnormalities (pain, necrosis, infarct, sclerosis, delayed healing) but also fractures, especially AFFs or stress fractures. A disorganized element is one that is where it shouldn't be (improperly stacked elements). Hence, disorganization can be measured by quantifying the extent to which a tissue (pixel within an image) is at an incorrect location.

组织紊乱和肌肉骨骼疾病:对无法解释的骨异常和脆性骨折之谜的新见解。
综述的目的:描述无序组织在骨异常和骨折发病机制中的潜在作用。特别是由于骨质流失(骨质疏松症)或结构恶化而无法解释的骨折。最近发现:目前,骨脆性主要被认为是由于丢失或腐烂(骨质疏松症)。然而,也承认这种观点是有限的,因为它不能解释许多骨折或异常,如坏死、硬化或梗死。抗吸收治疗中的非典型股骨骨折(AFFs)就是一个例子。因此,提出了另一种不同的机制是负责骨疾病。骨的一个不同于肿块和腐烂的显著特性是其组成部分的组织(排列)。组件必须完美地组装或堆叠,以确保“适量的骨头,在正确的地方”。紊乱是一种异常,在许多疾病中都很明显,在与骨量和骨质腐烂不良相关的情况下更是如此,如成骨不全症、低磷酸盐症和AFFs。然而,尽管紊乱可能起着关键作用,但这一特征却受到了有限的临床关注。这篇综述的重点是在健康和疾病中骨骼的潜在贡献。特别地,我们提出,由于负荷的无效转移,紊乱不仅可能导致骨异常(疼痛、坏死、梗死、硬化、延迟愈合),而且还可能导致骨折,特别是af或应力性骨折。无序元素是指出现在不应该出现的地方的元素(不正确堆叠的元素)。因此,可以通过量化组织(图像中的像素)在不正确位置的程度来测量无序性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Osteoporosis Reports
Current Osteoporosis Reports Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
8.80
自引率
2.30%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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